七氟烷合并胸椎旁神经阻滞对老年食管癌根治术患者氧合功能、血流动力学及术后恢复的影响

Effects of Sevoflurane Combined with Thoracic Paravertebral Nerve Block on Oxygenation,Hemodynamics and Postoperative Recovery in Elderly Patients Underwent Radical Esophagectomy

目的分析七氟烷复合胸椎旁神经阻滞对老年食管癌根治术患者氧合功能、血流动力学、认知功能及术后疼痛的影响。方法选择84例实施开胸食管癌根治术的老年患者,随机将其分为2组,2组患者均采用胸椎旁神经阻滞麻醉,参照组42例采用丙泊酚进行麻醉维持,观察组42例采用七氟烷进行麻醉维持。比较2组患者氧合功能、血流动力学及并发症发生情况。结果2组患者t2~t4时间点的OI均较t0时间点明显降低(P<0.05),且参照组的OI降低更为明显(P均<0.05);t5时点观察组OI明显高于参照组(P<0.05)。观察组t1、t2、t3时HR、MAP显著低于参照组(P<0.05)。观察组VAS评分、睁眼时间及拔管时间均低于参照组(P均<0.05)。2组不良反应发生率对比无明显差异(P均>0.05)。结论七氟烷合并胸椎旁神经阻滞用于老年食管癌根治术中麻醉效果好,能更有效地保护患者肺氧合功能,稳定血流动力学,减轻并发症,促进术后恢复。

Objective To investigate the effects of sevoflurane combined with thoracic paravertebral nerve block on oxygenation,hemodynamics,postoperative pain and cognitive function in elderly patients undergoing radical esophagectomy.Methods84 elderly patients scheduled for thoracic esophagectomy were randomly divided into 2 groups.Both groups received thoracic paravertebral nerve block anesthesia.The control group(42 cases)received propofol for anesthesia maintenance,and the study group(42 cases)received sevoflurane for anesthesia maintenance.Oxygenation function,hemodynamics and complications were compared between the 2 groups.Results OI of the 2 groups at T2-T4 was significantly lower than that at t0(P<0.05),and OI of the control group was significantly lower than that of the observation group at the same time(P<0.05);OI of the observation group at T5 was significantly higher than that of the control group(P<0.05).HR and map at T1,T2 and T3 in the observation group were significantly lower than those in the control group(P<0.05).The VAS score,eye opening time and extubation time of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Sevoflurane combined with thoracic paravertebral nerve block has a good anesthetic effect in elderly patients underwent radical esophagectomy.It can protect pulmonary oxygenation function more effectively,stabilize hemodynamics,reduce complications and promote postoperative recovery.